In honor of World Contraception Day, we chatted with Dr. Sophia Yen, MD, MPH (she/her), co-founder and chief medical officer of Pandia Health—the only women-founded and women-led birth control delivery service—about things you may or may not know when it comes to contraceptives. Let’s spill the BC pills. 💊

First things first: What are the different forms of contraceptives?
Here’s a list of contraceptives in the order of most effective to least effective:

  • Implant.
  • Vasectomy.
  • IUD with hormones.
  • Tubal ligation.
  • Copper IUD.
  • Shot.
  • Ring.
  • Patch.
  • Pill.
  • Condom.
  • Fertility awareness methods.
  • Diaphragm.
  • Spermicide.

Is any method of contraception 100% effective?
No, even vasectomies (which used to be the gold standard) fail 15 out of 10k people. The implant fails less than that!

How soon after giving birth should one start using contraceptives?
Most people with uteri are advised not to have sex for six weeks to allow healing. If you want to have sex sooner, then use condoms. At six weeks or later, you can consider hormonal birth control. You can also put in an IUD immediately after giving birth.

Can we get contraceptives for free?
If you’re low income, you can get contraceptives for free. Every state has Title X clinics, which are government-sponsored family planning clinics, and they have a sliding scale—meaning if you’re low income, it’s generally free. You can also try Planned Parenthood or apply to Pandia Health’s Birth Control Fund for free birth control pills.

What are the benefits and risks of common contraceptives?
Benefits of the birth control pill include a decreased risk of ovarian, endometrial, and colorectal cancer, a decreased risk of anemia, improved acne, and the ability to make periods optional. It can also treat PCOS and endometriosis.

The risks mainly include blood clots in people who are smokers and 35 or older or who have a history of blood clots. There’s also a slight increased risk of breast cancer, but the risk is small—an increase of 13 cancers per 100k women who use hormonal contraception for a year or one extra case of breast cancer each year per 7,690 women who use hormonal birth control. This is smaller than the increased risk of breast cancer from drinking three to six alcoholic beverages per week.

A lot has changed for the reproductive landscape since Roe V. Wade got overturned. Are emergency contraceptives still legal in all 50 states?
So far, but they are coming for it! Make sure you know about all the emergency contraception options. Here’s a list of the most effective to least effective options:

  • Copper IUD.
  • Hormonal IUD.
  • Prescription emergency contraception—ella® (ulipristal acetate).
  • Plan B and its OTC generics.
  • Yuzpe method (100 mcg of ethinyl estradiol +1gm of norgestrel or 500 mg of levonorgestrel now and again in 12 hours).

Have contraceptives themselves changed since the fall of Roe?
Contraceptives haven’t changed, but there is the first over-the-counter birth control pill coming in 2024. However, it was FDA-approved in 1973 and taken off market in 2005—not because of safety, but because the other options were better. If you can access a doctor, then you can get access to 40+ pills, the patch, the rings, and if in-person, the IUD, and implant, too. But if OTC is your only choice, then do that!

And finally, is there a method that’s the “best” contraceptive?
Each person with a uterus is different. Use the one that is most effective that you can tolerate and that best fits your lifestyle.